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N <br /> � �ketiOnFor O 2�2�98 I <br /> PUBLIC WORKS PERMIT °� �, <br /> PUDLJC WORKS DEPAR7MENT PuWfc Wqji permtt M ��/D.7 J <br /> 3200 Cedar Streat (j� <br /> Eve�ett,WA98201 �1D3 �� Building ItN 57$02 <br /> 1 � <br /> TO POSTING -- J <br /> TYPE OR PRINT ONLY �p�a�1�ks Fce f Zp� <br /> L�"J O 'J O O O :i 1 O� O P I <br /> i1. 00 OOId 'J [+J �t O p [� (n <br /> M� O UO �00 '+J UO .�-/ O �t �O � <br /> SELCO DFVFI pMFNT IN PO BOX 1S?4"'� NdHOhfl� �29q- 00 �' � <br /> Owner Mailing Address Cih Zip"� r� ¢ phone <br /> m <br /> p•. > <br /> RRIICF SFT 2N 4 S-75f1—i'i0 � J �v s k�� �� � � �-~. c <br /> Hppliwnt Mailing Address N j �J W�r,Y � �— �� o Phone <br /> GaU] 0. � ,.lL f� � � s U» F" <br /> Describe Proposed Work NEW DUPLER � <br /> � <br /> � <br /> PROJECT ADDRESS(if known) � <br /> Attach lour(4)mplas of plans for proposed work-Draw to scale and note the fo�lowing X applkable: � <br /> 'Property Lines 'Outline and dimensions of all existing and proposed structures on the bt •Ezlsting end proposed Wiltties O <br /> 'Centerline of street •Indicate NoAh 5how any proposed grading changes 5how measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. <br /> 2.All work shall be pertormed in accordance with this pertnit and current City of Evnrett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs, before you dig. TOLL FREE NUMBER 1-800-424-5655. .� <br /> �, W'vlllF� I�D� I'�N O{� 7�a �� �e,$2uX�{ � <br /> O <br /> � yrd25P,w�r �s PG►r S-,� p/?r, #Go/ � <br /> � <br />� ACKNOWLEDGEMENT OF CONDITIONS <br /> 7 ����,J�O> �G The un0ers{gned owner/epplkant heraby apiees to Irold and eave hgrmlesa <br /> �J���..K.^/ " ' `-'� z���� /� the Ciry ot Everett trom any and ell clalms for damege�,eosts.e�pensea.a <br /> App ved for C st ction i/ Date causes of aclion that may arise because of Installatbn and mNntenr�ce of <br /> /-i the improwe�nent or other rigM-of-way use M1xeto eppiied for and hxths apaes <br /> �% � to remove same upon rroHce hom the Gty and to replace public propeAy <br /> /�'� �..-C�i".. - d �� '!�g da therelry. <br /> FIRAL INSPECTION Date <br /> Approved as Consiructed c �j '1� � � <br /> ie ot pIi n <br /> WORK AUTHORIZED BY TIiIS P[qM1T MUST BE STARTED WITHIN 180 DAYS CF DATE PERMIT IS ISSUED AND THEREAFiER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEf10N.THIS PERMIT MHY BE CANCELLED 8Y THE C�UPON ANY STOPPAGE OF VVORlC ON THIS PPOJECT OVER 80 WVS WRATIpN, <br />